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Microvascular Complications of Food Insecurity in a Vulnerable Patient Population
Morgan Uebinger1, Megan Gremillion1, Stephanie M Provenzano1
1Department of Family Medicine, Louisiana State University Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
Diseases (Basel, Switzerland)
|July 27, 2026
Summary
Food insecurity combined with neighborhood disadvantage significantly increases the risk of microvascular complications in type 2 diabetes (T2DM). Addressing social determinants like food access is crucial for high-risk patients.
Area of Science:
- Public Health
- Clinical Medicine
- Socioeconomic Determinants of Health
Background:
- Food insecurity (FI) disproportionately affects low-income populations and is linked to poor type 2 diabetes mellitus (T2DM) control.
- North Louisiana exhibits high rates of FI, a critical factor in understanding T2DM complications.
- The interplay between FI and neighborhood socioeconomic disadvantage in T2DM microvascular complications requires further investigation.
Purpose of the Study:
- To evaluate the relationship between FI, socioeconomic disadvantage, and microvascular complications in T2DM patients.
- To assess the combined impact of FI and neighborhood deprivation on diabetic complications.
- To identify specific microvascular complications associated with these factors.
Main Methods:
- Retrospective cohort study of 163 T2DM patients in North Louisiana (2018-2023).
- Utilized electronic medical records to extract FI status (Hunger Vital Sign tool), Area Deprivation Index (ADI), and microvascular outcomes (nephropathy, neuropathy, retinopathy).
- Analyzed the association between FI, ADI, and microvascular complications, including interactions.
Main Results:
- FI alone was not a significant predictor of nephropathy (MACR).
- The combination of FI and high ADI (≥7) was significantly associated with neuropathy (p=0.024) and retinopathy (p<0.001), especially in patients with T2DM >5 years.
- The interaction of FI and high ADI significantly influenced MACR values (p=0.026), suggesting exacerbated kidney dysfunction.
Conclusions:
- Food insecurity coupled with socioeconomic adversity increases the risk of microvascular complications in T2DM.
- Highlights the importance of integrating FI screening and addressing social determinants of health in high-risk populations.
- Emphasizes the need for early identification and targeted interventions to mitigate T2DM progression and reduce health disparities.
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